Q&A with Sir Elton John
HIV/AIDS We spoke to Sir Elton John, the founder of Elton John AIDS Foundation, about the current state of HIV and AIDS in the UK, and throughout the rest of the world.
We know that around 13% of those living with HIV are unaware they have it – what more can be done to normalise sexual health testing and empower people to take ownership of their status?
"There’s lots of reasons why people don’t know their HIV status: not knowing the risk, hard to find somewhere to test, being scared of what you might find out….
"Social media is a powerful way to dispel fears and myths."
"These are all challenges we can overcome. Finding the right platform – face to face, social media etc – and the right messenger to explain that HIV testing is important, easy, and it works is a powerful way to dispel fears and myths.
"HIV test kits are cheap, reliable and increasingly can be done at home. And HIV testing can reach people where they are: a football match, a music concert, a corner store or online. UNITAID is doing a great job of getting HIV self-testing to programmes in Africa.
"Ultimately, HIV needs to be just part of good health care, not a separate, scary, shameful disease. We have to get rid of the stigma of HIV. Making HIV testing as widespread as possible makes it normal and not shameful. When we can talk about HIV like we do about diabetes, then everyone can own their status."
What do you consider to have been the ‘game-changing’ medical and social advancements, with regard to HIV and AIDS, in the last 20 years?
"One thing we’ve learned about HIV/AIDS is that there’s no magic bullet.
"I’m really proud to have helped over 800,000 women have HIV-free babies."
"But there have been some huge leaps forward. Firstly the drugs themselves. I remember when people got an HIV diagnosis and just went home to die. When ARV therapy came along, it was like a miracle! Then we found out that drugs could prevent transmission of HIV from mother-to-child - amazing!"
"I’m really proud that the Elton John AIDS Foundation helped over 800,000 women have HIV-free babies. Today we are looking at the next generation being AIDS-free.
"Finally the HPTN 052 study that showed people who stay on good HIV medicine are up to 96% less infectious. That was extraordinary. And looking into the future, I think anti-HIV medication PrEP has a huge role to play in keeping people safe."
New figures show the biggest ever drop in new diagnoses of HIV*. How can we continue this trend and do you think that we can reach a point where we have eliminated HIV transmission in the UK?
"The change in the UK epidemic is so exciting. Again, no magic bullet but some big wins. Making sure people know their status and get on treatment quickly is crucial.
"Offering PrEP for people at risk is having a big impact. The Elton John AIDS Foundation funded PrEPster and IWantPrepNow to accelerate access to this important tool and I’m full of admiration that NHS England will make PrEP available to 10,000 people. Prevention rather than cure!
"A new scheme to automatically test EVERYONE who is brought into A&E for HIV."
"And then there’s finding people who are living with HIV but have really been missed – the late diagnosed. Last year, I visited King’s College Hospital where we funded a new scheme to test EVERYONE who is brought into the Emergency Dept for HIV. The hospital is in a high HIV prevalence area, so it makes sense, right? The scheme found people who’ve been sick for a long time but were never tested before."
"So we think there needs to be more of this. My Foundation is launching a scheme working with local councils in South London, and NHS England to find many more of the 4,400 people in London who are living with HIV but don’t know it.
"If PreP can help prevent new infections and we can get everyone infected onto to treatment, then yes I absolutely believe we can beat AIDS in the UK."
What are the greatest challenges that still need to be overcome in the fight against HIV/AIDS?
"The biggest is stigma. Shame really. Shaming and blaming people for having a disease that anyone can get.
"We have to lose the 1980s ‘plague’ associations. We have to stop making people feel ‘less than’ because of their sexuality or their vulnerability to infection. Only AIDS wins down that path."
When it comes to HIV and AIDS, what do we need to educate people about?
"That AIDS is not a death sentence. People can live normal, healthy lives with HIV. They can have HIV-free babies. They won’t pass the virus on to other people if they are on treatment. That love, not hate, is the cure."
Sir Elton John and David Furnish visit a mothers2mothers clinic in Cape Town. Photo credit: Polly Steele
*figures by Public Health England